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3 Pros of Bilateral Knee Replacement on the Same Day
1. Decreased Risk of Infection
2. Quicker Overall Recovery
3. Decreased Cost
Cons of Bilateral Knee Replacement on the Same Day
1. Increased Physiologic Demand
2. You Might Not Need The Second Procedure
3. Return to Work Slower
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0:00
Hey guys, Tony Maritato here and I want to talk about the pros and cons of having a bilateral
0:06
total knee replacement done on one day as opposed to having those two procedures spread
0:12
out over a 6-12 week time frame. So I can tell you that in my clinic here in Ohio, I typically see patients have the first
0:20
total knee replacement done and then anywhere between 6 and 12 weeks they have the second
0:24
procedure done. But about 10 years ago, it was commonplace to have a person have both knees
0:31
replaced on the same surgical date. So there are definitely pros and cons, and there is more and
0:37
more clinical research coming out on the topic. But I'm just going to hit three pros and three cons
0:42
for having a bilateral knee replacement done in one day. So the first one is decreased risk of
0:49
infection. And this is one of the pros. This is one of the benefits. If I have to have a procedure
0:54
that opens me up to possible infection. I'd rather get everything done in one day. So I reduce my
1:01
episodes of exposure as opposed to going into the hospital, having the first knee done, then six
1:07
weeks later going back into the hospital for the second knee. So we know that post-surgical
1:12
complications associated with an infection is a very real risk. And the more we can decrease that
1:19
the better. So one of the benefits of having them both done on the same day is decreased risk of infection
1:25
The second reason is quicker overall recovery. Now in my experience in my physical therapy clinic
1:30
when a patient comes in with a bilateral knee replacement done on the same day, they typically take about the same
1:36
amount of time the same number of weeks to recover from a double as they do to recover from a single And so if I going to try to minimize my recovery time
1:50
because maybe I wanna get back to work or I need to help around the house or my family
1:55
it might be in my best interest to have both knees replaced on the same day
1:59
Now, there's a bias here because it might be a situation where people who are having a bilateral knee replacement
2:05
on the same day are good healers. They're in great shape. They're otherwise healthy
2:10
and that's why they're healing more quickly. I don't know. I don't have the research in front of me
2:15
but I can tell you that my experience has been, whether it's one knee replacement or both
2:22
I find that patients tend to take about the same amount of time to recover from the procedure
2:27
And then the third benefit of having it done on the same day is decreased cost
2:32
Now, I'm not talking about the decreased cost of the surgery. I'm talking about the decreased cost to you in terms of if you're taking time off of work
2:41
Taking six weeks off or 12 weeks off might be better than having to double it if you're having this procedure done on separate dates
2:51
If you have to hire somebody to mow the grass or you have to outsource laundry and meal prep
2:56
it might be more cost effective to have it all done in one shot as opposed to having two completely separate surgical recoveries
3:04
So there are more benefits that I'm not outlining here to having them both done on the same day
3:11
But let's talk about some of the drawbacks, some of the cons of having a bilateral knee replacement on the same day
3:17
So the first one is the impact the physiologic demand on your body You are going into major surgery when you having a knee replacement So having one is enough of an impact Having two you might not be medically
3:32
stable enough to manage the trauma of having a bilateral knee replacement done on the same day
3:39
And most of the clinical research that I've seen suggests that it is the physiologic impact that
3:46
has moved kind of the paradigm to let's do one, let's let the patient recover, and then let's do
3:53
the second one. You know, one of the biggest cons to having a bilateral knee replacement done on the
4:00
same day is you might not need the second knee replacement. And so it is an occurrence, I'm not
4:07
going to say frequent, but it is an occurrence where in my clinic a patient will have the first
4:11
knee replacement done. It's usually the knee that's causing more problems. And during the recovery
4:16
process they find that the second knee which might have been scheduled for surgery doesn't
4:22
need the surgery anymore. Maybe the function of the second knee improves because when we're
4:26
rehabbing the surgical knee we're also rehabbing the non-surgical knee. Maybe the pain decreases
4:32
maybe the improvement in the first surgery and the mechanics of that knee take some of the load
4:39
off the second knee and they find that they're able to delay or completely prevent having a second
4:46
knee replacement. So by spreading the knee replacements out over different surgical dates you might find that you only need one knee to be replaced. The
4:55
third kind of con of having them both done at the same time goes back to the potential for a slower recovery the potential for more time off of work So while I know that having two separate surgeries might be more beneficial or more complicated trying to squeeze
5:15
everything into one recovery, you just might not be able to do that. And so what I have found is
5:24
that the, and you guys know this because you're in it, the lack of sleep, the depression, the anxiety
5:30
the socioeconomic effect, the psychological effect of having a bilateral knee replacement
5:38
could be one in which if you're trying to get back to work quicker and more effectively
5:46
you might not be able to do that because of the trauma of a bilateral knee replacement
5:51
So we want to weigh all of the factors, all of the variables, look at the risk
5:57
look at the benefit and make your decision with the support of your physical therapist
6:03
with the support of your surgeon and your family, because I would genuinely say there
6:08
is no right or wrong answer. You're going to make a decision. There could be negative consequences to either decision
6:16
We just have to do the best that we can to be prepared for whatever comes down the road
6:21
You know, we want to hope for the best. we want to prepare for the worst but never double guess or second guess your decision because
6:28
there is no right or wrong decision in this case. I appreciate you watching the video if you have
6:34
more questions let me know if you want to join the Facebook group it's the total knee replacement
6:38
support group for kind people on Facebook it's totally free we have about 7,000 members right
6:44
now and the group is just fabulous I will catch you guys on the next video
#Arthritis
#Physical Therapy
#Surgery